Mistakes in the ED

The kind of mistakes I make during my shift in the Emergency Department aren't usually the high-risk, life-endangering type. After all, we volunteers have probably the least amount of medical training of all the staff, aren't really certified in anything except CPR, and can be the greatest liabilities to the hospital.

While we do get to do cool things like observe traumas and random tasks (once, a resident asked me to fish a vial of morphine out of his chest pocket--umm...awkward), the minor procedures we perform are relatively safe and easy. Like EKGs: stick leads on patient's chest and limbs. Attach alligator clips. Print EKG report. Get attending's signature. Sprinkle with a generous dose of hospitality, small talk, and smiles. No one gets hurt. Except if you accidentally clip a leg hair or a chest hair--whoops! gotta be careful about them hairy types.

If a patient asks for food or water, we volunteers are required to ask nurses rather than act out of pity or of our own accord. Sure, the poor guy in bed 10 might wheezily ask for water--but if he's on certain medications or scheduled for surgery, then no, he can't have anything to eat or drink. In those cases after confirming with the nurse, I put on my best sympathetic look, ask him if he needs anything else (like a blanket or pillow), and that's that. Or the woman in bed 35 might need to use the bathroom--but if she's going to ultrasound, then no, she needs a full bladder for the procedure. The same precaution applies to patients that are diabetic, hypertensive, or lactose intolerant. There's very little we really know about the patients from just looking, and asking the nurse is the most important thing a volunteer can do.

That brings me to the biggest mistake I've made at the ED. No, it wasn't a medical mistake. It was a social one. Even though it happened months ago, I've never forgotten it.

A nurse had told me to bring a patient a cup of water. When I got to the room, I handed the patient the cup, smiled, and said, "Here you go, sir." I always try to address the patient respectfully, with a proper salutation, because that's just how I was raised. The patient replied, "Thank you." In a woman's soft voice. It instantly clicked in my head that the bald head, the thin torso, the sullen face, all belonged to a woman undergoing chemotherapy for breast cancer. My smile fell. I was horrified at my own ignorance, or was it insensitivity? I mumbled "Have a good day" or something as I left the room quickly. How awful it must be to have her femininity taken away, to be mistaken for what she isn't, to be reminded of the outward condition of her illness. I avoided that room for the rest of my shift, because I was too ashamed to approach that woman again.

While there's nothing I can do now about that unfortunate interaction, I've been learning and taking precautions. I glance at patients' wristbands or charts and make sure I know their names. In a gloomy place where even nurses don't always know their own patients' names (and doctors even less so), I feel that addressing people properly and with dignity is something that I can do. I make eye contact with patients whenever I'm strolling through the wards. I smile and ask if they need anything. I cover up toes peeping out from under blankets. There isn't much that I can do for patients (yet), but I can treat people well. And I hope it makes a difference.